The Pennsylvania Department of Health is now aware of at least 13 people infected with E. coli O157:H7 who swam in the lake at Cowans Gap State Park.

In a brief e-mail statement this afternoon, press aide Thomas Hostetter said the current numbers include six people from Franklin County, four from Lancaster County, and one from Huntingdon County. There are also two Maryland residents who got sick after visiting the park.

Hostetter said the E. coli outbreak at Cowans Gap remains under investigation, and that more updates will be released as they become available.
 

Yesterday I received a question from an extension agent about some exploding jars of home canned salsa. The agent said that a new canning enthusiast made the salsa without following a tested recipe, and omitted the addition of vinegar. Vinegar is important in home canned salsa as it lowers the pH and changes the environment so Clostridium botulinum spores can't germinate and produce toxin. Two weeks later, not only does the dude have a mess in his pantry but he's also increased the risk that bot toxin has been spewed around his house.

Not all the jars exploded, just a couple, so the canner wondered if the remaining jars were safe to eat (they aren't). He didn't want to throw out the fruits of his labor, but also didn't want to make people sick, so he checked with the resource person in his county. That's good.

Botulism problems with home canned products aren't new at all. Dave Olsen of the Fargo-Moorhead Forum wrote today about a tragic 1931 botulism outbreak that killed 12 people in Grafton ND (that's fairly close to Canada). The deaths were linked to improperly canned peas that were served at a dinner party hosted by Edward and Delphine Hein.

Delphine served a salad sprinkled with peas she had canned herself.
Within days, 12 people and later a 13th would fall ill and die, including the Heins and three of their six children.
Three Hein children, Richard (Dick), Marvin (Bud) and Wilfred (Bill), were too young to attend the party and spent the evening in their rooms.  “That was a lucky break for us,” said Dick Hein, who is now 94 and lives in Detroit Lakes. His brother, Bud, is 84 and lives in Grand Forks. Bill Hein, who was 12 years old when the three brothers missed the party that fateful night, died about five years ago, Bud Hein said.

After the tragedy, the three boys found separate homes with aunts and uncles, though Dick Hein said he soon became restless and moved out to work as a laborer for farmers in the area. Hein, who has three sons of his own, said the parents he lost all those years ago are always near his thoughts, as are two sisters, a brother and a cousin who died from eating the salad.

The two surviving Hein brothers say they had to grow up quickly following their parents’ deaths. A front-page story in the Walsh County Record from Feb. 5, 1931, described the 13 deaths as the worst tragedy in North Dakota’s history. A back-page story quoted a then 14-year-old Dick Hein as asking: “Please, will you see that our mother’s wedding ring is saved so that we will have something to remember her by?”

“If only one of our sisters had lived,” the boy added, “then we could have continued to operate the farm as our father has in the past.”
 

More than a year after New york City first required restaurants to post Health Department inspection grades, some owners of Greenwich Village eateries are doing their best to hide less than perfect ratings.

Andrea Swalec of DNAinfo writes that Famous Ray's Pizza of Greenwich Village racked up 54 violation points in a June 7 health inspection, but its posted C grade — the lowest mark a restaurant can get without being shut down — was nearly impossible to see when DNAinfo looked for it last week.

Only a pale outline of a C, which is usually bright gold, was visible at the Sixth Avenue pizzeria, at 11th Street.

"Why does it matter?" a Famous Ray's manager who would not identify himself said by phone when DNAinfo called to ask why the sign wasn't clearer.

Health Department rules require grade signs to be posted "on a front window, door or outside wall where it is easily seen by people passing by." The card must be placed within five feet of the entrance, from four to six feet off the ground.

The pizza joint was inspected again Aug. 11 and received 26 violation points — which earns it a B grade.

However, its offenses include "evidence of mice or live mice present in facility's food and/or non-food areas," according to city Health Department restaurant inspection data.

At the Subway sandwich shop at 315 Sixth Avenue, DNAinfo noticed on Aug. 8 that its C grade was posted on an easy-to-miss side window, between bright promotional signs.

Subway moved the sign to the shop's door after a reporter pointed out its placement.

"We have moved it. Thanks for letting us know," manager Mohammed Mazar said when asked to comment on the sign.

The sandwich shop was cited for evidence of mice, improper sanitation of food preparation surfaces and not keeping cold foods cold enough, records show.

The Health Department has issued 123 violations to restaurants that did not place grade signs in the required locations, according to a department report on the first year of the grading system.

Rule-breakers can be fined as much as $1,000 for a first offense and $2,000 for subsequent offenses.

Nearly 90 percent of New Yorkers surveyed in July by Baruch College said they considered restaurant grades when deciding where to eat.

That's what I told Chris Woolston of the Los Angeles Times last week when he asked me what I look for in a restaurant inspection report.

Handwashing compliance and cross-contamination are two of the factors WHO and CDC have identified as often linked to illnesses and outbreaks. And they are also pretty tough to inspect for in the short time that an environmental health officer is in a kitchen. Folks act different when the inspector is around so when handwashing problems show up on an inspection report I get the sense that the place doesn't have a great food safety culture.

Another violation I look for on an inspection report is cross-contamination -- but it's a pretty complex process that takes time and often does not make an inspection report.  In our infosheet evaluation study we saw raw chicken cut on a cutting board by one staff member and 20 minutes later a different food handler used the same knife and cutting board to chop up a head of lettuce. Pretty hard for an inspector whose departmental budgets are stretched to sit and watch a few pieces of equipment for 20 or 30 minutes waiting for the magic event.

In our study, we had cameras.

Woolston writes:

Restaurant inspections have definitely helped prevent outbreaks across the country, says food safety expert Margaret Binkley, an assistant professor in the department of consumer sciences at Ohio State University in Columbus. But the grades hanging in the window — or even a full report on public health websites — offer only a vague glimpse of the real risk of foodborne illness, Binkley says. "These places are often open 365 days a year, 12 hours a day," she says. "A two-hour inspection is only going to be a very small snapshot."

Out of necessity, inspectors tend to focus on things that can be easily checked, such as the temperature of a walk-in fridge, the cleanliness of the floors and countertops or whether cockroaches and mice have set up shop in the pantry. But these factors may not have much to do with actual diseases, says Benjamin Chapman, a food safety specialist at North Carolina State University in Raleigh. "You can't look at an inspection report and know how likely you are to get sick," he says.

Chapman says he would want to know one thing about a restaurant — and it's not the health score. "I want to know whether workers are washing their hands."

He notes that noroviruses — a leading cause of foodborne illness — are spread primarily through contaminated hands. (These viruses, which have also made the rounds on cruise ships in recent years, can cause diarrhea, vomiting, muscle aches and a mild fever.) And, he adds, restaurants often get shut down for violations that are much less dangerous than unwashed hands. "A cockroach infestation is not going to increase the chances that you're going to get sick."

As my friend Mag Binkley points out, there are limitations of any inspection posting regime because an inspection only reflects conditions at one point in time (and there are other influences like variability between jurisdictional focus and inspector biases). However, the information collected by inspectors, no matter how limited, needs to accessible and clear. 

Inspection results aren't going to tell anyone how likely they are to get sick from eating at a place but accessibility to reports is a must, even if it's just a snapshot - because it's a chance to increase dialogue around food safety.
 

Ottawa Public Health is debating whether to force all food handlers in the city to take a mandatory food safety course.

Parenting and preparing food are about the only two activities that do not require some kind of certification in Western countries. For example, to coach little girls playing ice hockey in Canada requires 16 hours of training. To coach kids on a travel team requires an additional 24 hours of training.

Anyone who serves, prepares or handles food, in a restaurant, nursing home, day care center, supermarket or local market needs some basic food safety training.

Sherry Beadle, Ottawa health department's program manager of food safety, said, "The difference with this certification program is it allows a greater in-depth look at food handling practices. Training is always a good thing."

Not if the training is mind-numbingly dull, trying to transform line cooks or servers into microbiology or HACCP experts. That’s why training needs goals and continual evaluation.

There could be mandatory food handler training, for say, three hours, that could happen in school, on the job, whatever. But training is only a beginning. Just because someone is told to wash the poop off their hands before they prepare salad for 100 people doesn't mean it is going to happen; weekly outbreaks of hepatitis A confirm this. There are a number of additional carrots and sticks that can be used to create a culture that values microbiologically safe food and a work environment that rewards hygienic behavior. But mandating basic training is a start.

Eight of Ontario’s 36 health units currently require mandatory certification.

The course should be mandatory, and then should be evaluated and improved so that food service employees actually use what they allegedly learn, with the ultimate goal of reducing the number of foodborne illnesses.

And the best establishments won’t wait for government. Ottawa restaurant owner Daoud Ahmadi, who has been in the food industry for 13 years, told CBC News it should be a mandatory course for anyone who handles food and that he expects all his new employees to take the course even though it is currently voluntary.

"It is really important for people that are working on the food," Ahmadi said.
 

The U.K. Health Protection Agency reports a link has been established between a batch of imported eggs and an outbreak of Salmonella Enteritidis Phage Type (PT) 14b infection in England and Wales.

Two hundred and twenty-one cases of Salmonella Enteritidis PT 14b infection have been reported since the beginning of this year, the majority of cases being in North West England (104 cases), the West Midlands (36 cases) and the East Midlands (26 cases).

Dr. Joe Kearney, an HPA director who chairs the outbreak control team (OCT), said:

"A strain of Salmonella Enteritidis PT 14b that is indistinguishable from samples taken from the human cases was isolated from a small number of eggs that had the same batch number.

"These eggs had come from a specific shed on one farm in Spain. The Food Standards Agency (FSA) alerted the Spanish authorities and measures were taken to eliminate the risk of contamination from this source, including the culling of a flock of hens, the cleaning of the shed and the heat treatment of eggs to kill salmonella.

"No eggs with the implicated batch number have been imported to this country since the end of June. The FSA alerted Environmental Health Officers throughout England and Wales to the situation and checks were made and continue to be made on the distribution chain. Whenever eggs with the implicated batch number are found in the system, these are removed from sale. In the meantime our investigations are continuing."

Traducido por Gonzalo Erdozain

Resumen del folleto informativo mas reciente:

- Cargill Meat Solutions Corporation ha retirado del mercado mas de 36 millones de libras de carne molida de pavo.
- Mas de 30 productos han sido retirados del mercado; todos con el numero P-963 dentro del sello de inspección de la USDA.
- Pregunte a los proveedores acerca de medidas para el control de patógenos.
- Cocine toda carne de aves a 165°F usando un termómetro digital como control.

Los folletos informativos son creados semanalmente y puestos en restaurantes, tiendas y granjas, y son usados para entrenar y educar a través del mundo. Si usted quiere proponer un tema o mandar fotos para los folletos, contacte a Ben Chapman a benjamin_chapman@ncsu.edu.

Puede seguir las historias de los folletos informativos y barfblog en twitter
@benjaminchapman y @barfblog.
 

County health inspectors closed Marinepolis Sushi Land in downtown Bellevue, Washington, at 4 p.m. Thursday after two separate patients with salmonella were connected to the restaurant, according to Seattle and King County Public Health.

The two people who fell ill were not hospitalized and have recovered from their illnesses, said James Apa, spokesman of Seattle and King County Public Health.

Marinepolis manager Keith Negley told the Bellevue Patch the restaurant, a conveyor belt style sushi restaurant, is cooperating with the investigation fully, and could be reopen as soon as Friday.

"We're doing everything we can to assist, even if it's a potential that it could have been through here," he said.

Yesterday, U.S. CDC provided updated information concerning a Salmonella Heidelberg outbreak that has been linked to Cargill Meat Solution Corporation's ground turkey products. Below is a food safety infosheet that discusses recall actions and risk reduction strategies for food service operators.

Food Safety Infosheet Highlights:
- Cargill Meat Solutions Corporation has recalled over 36 million lbs of ground turkey products
- Over 30 products have been recalled; All bear the number P-963 inside USDA inspection mark
- Ask suppliers about pathogen control measures.
- Cook all poultry to 165°F, measured with a digital tip-sensitive thermometer.

You can download the infosheet here.